Treating depression improves diabetes control

NEW YORK (Reuters Health) - A study of type 2 diabetics with depression confirms that depression has a negative impact on glycemic (blood sugar) control, researchers report, and "affirms the importance of depression management in diabetic patients in its potential to improve glycemic control."

Researchers from Missouri treated 93 patients with type 2 diabetes and depression with the antidepressant bupropion (Wellbutrin).

"We selected bupropion because it is capable of reducing depression and weight simultaneously and hypothesized that these effects would be accompanied by improved glycemic control in diabetic patients with major depressive disorder," the team explains in the journal Diabetes Care.

In support of their hypothesis, "antidepressant treatment produced benefits beyond just mood improvement," first author Dr. Patrick J. Lustman from Washington University School of Medicine, St. Louis, told Reuters Health. "Patients also lost weight, improved self-management of their diabetes, and improved their glucose control (A1C levels)."

Of these short-term improvements, only depression improvement predicted maintenance of improved blood sugar control in the subsequent 6 months, the researchers found.

"This confirms our hypothesis that depression improvement can produce better glycemic control, independent of favorable changes in weight and diabetes self care," Lustman noted. "Improvement in depression was the key to achieving longer term improvements in glucose control."

Lustman concludes that the data "point to the importance of weight-independent physiological factors (insulin sensitivity, inflammation) that improve during depression relief and contribute to better long-term control of diabetes."

SOURCE: Diabetes Care, March 2007.